Which of the following is not characteristic of cognitive impairment?

A. Teach the mother about symptoms of UTI is not the nurse's first priority. While educating the mother about UTIs is important, the presence of bruises in the genital and rectal areas raises immediate concern for potential sexual abuse, which requires immediate action to ensure the child's safety.
B. Report suspected sexual abuse to protective services is the nurse's first priority. Any signs of physical trauma or injury in areas typically covered by clothing, such as the genital and rectal areas, must be reported immediately. The nurse is a mandated reporter and is legally required to report any suspected abuse. Ensuring the safety of the child is paramount, and protective services will investigate the situation and take appropriate steps.
C. Interview mother for child’s health history may be necessary later, but at this moment, the immediate concern is the possibility of sexual abuse. The nurse should report the findings to the appropriate authorities before discussing the situation further with the mother.
D. Obtain a urine sample to confirm UTI is important for diagnosing the UTI but does not address the immediate concern regarding possible abuse. The child’s safety and well-being must be prioritized, and reporting the possible abuse is more urgent than confirming the UTI at this point.

A. Obtain information as covertly as possible is not recommended. While it's important to handle the situation with sensitivity, the nurse should maintain transparency and create an environment where the family feels safe to share information. Covert questioning can raise suspicion and might not facilitate open communication.
B. Avoid responding to hints that abuse has occurred is not appropriate. If there are hints of abuse, it’s crucial for the nurse to respond with empathy, concern, and to acknowledge those hints, as this can help the child and family feel supported. Ignoring signs of potential abuse could lead to further harm.
C. Be open, concerned, and honest is the best approach. The nurse should express concern in a non-judgmental, empathetic manner. This builds trust and encourages the family to provide accurate information, which is crucial for the child’s safety and well-being. It also ensures the nurse can assess the situation appropriately.
D. Separate the family from the child during the interview may be necessary in some cases if the nurse suspects abuse and needs to speak with the child alone to avoid further pressure or influence from family members. However, this is not a first-step intervention; it should only be done if the nurse has reason to believe that the family’s presence may hinder the interview or prevent the child from being honest.